Markers of fungal translocation are elevated during post-acute sequelae of SARS-CoV-2 and induce NF-κB signaling, 2022, Giron et al

Discussion in 'Long Covid research' started by Andy, Jun 22, 2022.

  1. Andy

    Andy Committee Member

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    Long COVID, a type of Post-Acute Sequelae of SARS-CoV-2 (PASC), has been associated with sustained elevated levels of immune activation and inflammation. However, the mechanisms that drive this inflammation remain unknown. Inflammation during acute Coronavirus Disease 2019 could be exacerbated by microbial translocation (from gut and/or lung) to blood. Whether microbial translocation contributes to inflammation during PASC is unknown.

    We did not observe a significant elevation in plasma markers of bacterial translocation during PASC. However, we observed higher levels of fungal translocation – measured as β-glucan, a fungal cell wall polysaccharide – in the plasma of individuals experiencing PASC compared to those without PASC or SARS-CoV-2 negative controls. The higher β-glucan correlated with higher inflammation and elevated levels of host metabolites involved in activating N-Methyl-D-aspartate receptors (such as metabolites within the tryptophan catabolism pathway) with established neuro-toxic properties. Mechanistically, β-glucan can directly induce inflammation by binding to myeloid cells (via Dectin-1) and activating Syk/NF-κB signaling.

    Using a Dectin-1/NF-κB reporter model, we found that plasma from individuals experiencing PASC induced higher NF-κB signaling compared to plasma from negative controls. This higher NF-κB signaling was abrogated by Piceatannol (Syk inhibitor). These data suggest a potential targetable mechanism linking fungal translocation and inflammation during PASC.

    Open access, https://insight.jci.org/articles/view/160989
     
  2. Jacob Richter

    Jacob Richter Established Member (Voting Rights)

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    Does anyone with more medical knowledge than me know what "fungal translocation" really means in this context? Any views on the credibility and/or usefulness of this tentative finding?

    Thanks!
     
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  3. Midnattsol

    Midnattsol Moderator Staff Member

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    "Translocation" is that the fungi has moved from one compartment of the body (like the gut or lung) and into circulation, and as it says can trigger an immune response. Then they go on to talk about what this inflammation response can lead to. Translocation would mean barrier tissues that keep these microbes out of circulation is impaired, which has been shown in pwME as well (increased translocation of bacteria following exercise).

    How useful it is? Who knows. I haven't read more than the abstract so they might explain more in the article itself. On a more general note, impaired barrier tissue is not uncommon and is seen in many chronic (and acute) conditions. With inflammatory bowel disease, some can be treated by changing their diet and improving the integrity of the intestinal wall to reduce inflammation, and recently in a mice study increased fiber intake was also linked to skin barrier health.

    Similar proteins that is seen in the intestinal wall and the skin are found in epithelium in the lungs, and also in the blood-brain-barrier. So at least to me it's interesting, as maybe an impairment of the blood brain barrier contribute to brain fog? And low grade inflammation following translocation of bacteria following exercise could contribute to PEM.
     
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